Comparison of ultrasound diagnostics and laparoscopic findings in case of acute abdominal pain in girls

Abstract

Introduction: One of the most common reason for a visit to an emergency department of the girls of all ages is abdominal pain. Abdominal pain can develop due to many etiologic factors – both acute and chronic. However, several conditions need to be evaluated and treated in pressing manner, as they Associate with high morbidity and mortality. Aims: To compare ultrasound and laparoscopic findings, and to evaluate the role of early laparoscopy management of abdominal pain in girls in a prospective, randomized, single-institution trial. Materials and methods: The analysis of ultrasound diagnostics effectiveness of acute abdominal diseases Associated with abdominal pain inpatient girl age from 3 to 17 years in Odessa Regional Children's Clinical Hospital has been performed. 171 patients were enrolled in the analysis held from 2010 to 2015yr. Inclusion criteria were – presence of sharp abdominal pain lasting more than 6 hours and less than 5 days, without fever, leucocytosis, or obvious peritoneal signs and uncertain diagnosis after physical examination and baseline investigations. For all girls ultrasound (US) examination of abdominal cavity was performed. Condition of girls were observed in clinic for 3 to 6 hours, if diagnosis still was unclear with routine tests (US data were not taken into account), the laparoscopy was performed. The US data were compared with laparoscopy findings.Conclusions. Sonography of the abdomen is an effective screening method for diagnosing acute surgical diseases in girls with abdominal pain. High operator dependence can be considered as a disadvantage of this method. In addition, due to diagnostic and treatment advantages, laparoscopic surgery is useful for majority of conditions underling unclear abdominal pain in girls. So the comparison of US and laparoscopic findings, and early usage of laparoscopic intrusions gives opportunity to avoid unnecessary surgical aggression in 27.5%. Moreover, 68.0% of patients, surgical problem was revealed and treated in early period. Early laparoscopy reduces the rate of surgical complications. Evaluation of symptoms severity should lead to laparoscopic intrusion if routine diagnostic methods have failed to yield results. A necessity to review some principles of specialists’ training for diversified general surgical hospitals has been appeared. It is expedient for surgeons to complete basic professional retraining with mastering of related specialties, particular ultrasound diagnostics and endoscopy.